Are maternity experiences of rural women getting better with time? Results from a survey in Tasmania

This study investigates the maternity experiences of rural women in Tasmania; and whether the childbirth experiences between women who have had childbirth experiences within the last five years and those more than five years ago are different due to closure of local maternity services. A questionnaire explored women’s experiences of rural maternity services from antenatal to postnatal care in six rural communities in Tasmania, Australia. 210 women completed the questionnaire with a response rate of 35%. Nearly 50% (n=100) of surveyed women did not have a choice where they could get antenatal care, while more than 50% (n=108) of participants lacked the choice about who would provide care during their pregnancy. Women who gave birth recently were more likely to have to travel further to the nearest maternity units. These women were less likely to experience continuity of care and to be satisfied with the antenatal care and care during labour. In contrast, the women who gave birth more than five years ago had shorter travel time to the nearest maternity units and were more likely to have experienced continuity of care and greater satisfaction with care given during their pregnancy, labour and delivery. Maternity experiences of Tasmanian rural women have not improved with time due to the closure of small rural maternity units. Reopening small rural maternity units would not be feasible with the current shortage of health workforce in Australia. However, in order to improve maternity experiences for rural women, it is recommended that basic services including antenatal and postnatal services should be provided in their local communities. The existing maternity health providers in rural communities such as GP obstetricians and multi-skilled rural nurses should be encouraged and provided with incentives to deliver greater antenatal and postnatal care for women. In addition, maternity health providers from major hospitals could come to a local hospital regularly to provide antenatal check-ups and antenatal classes. This will reduce the need of traveling to access services and increase opportunities for continuity of care which in turn may increase the satisfaction with care of rural women.